Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01844 | Date 01/11/2018 |
| Token No | SM/18-19/3314 01/11/2018 | Serial | 063 Last Visit: 01/11/2018 |
| Patient Name | Mr. ALOK DAS | Contact No | 6290364908 |
| Address | CHATRA DHARMATALA LANE | Age | 38 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||